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Updated: Feb 13, 2026
Acute Myocardial Infarction in Rats
Published on: February 16, 2011
Predictive and protective role of high-density lipoprotein cholesterol in acute myocardial infarction
Jin Sup Park1,2, Kwang Soo Cha3,4, Hye Won Lee1
1Department of Cardiology, Pusan National University Hospital, Busan, South Korea.
Insights
In patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) and statin therapy, low high-density lipoprotein cholesterol (HDL-C) increases cardiovascular event risk. High HDL-C may reduce this risk.
Area of Science:
- Cardiology
- Clinical Research
- Biochemistry
Background:
- Uncertainty exists regarding the predictive value and protective role of high-density lipoprotein cholesterol (HDL-C) in acute myocardial infarction (AMI) patients receiving percutaneous coronary intervention (PCI) and statin treatment.
- Investigating HDL-C's impact is crucial for optimizing cardiovascular event risk stratification and management in this patient population.
Purpose of the Study:
- To determine if high-density lipoprotein cholesterol (HDL-C) levels predict cardiovascular events in patients with acute myocardial infarction (AMI) treated with percutaneous coronary intervention (PCI) and statins.
- To assess the potential protective effect of high HDL-C levels in this specific patient cohort.
Main Methods:
- A cohort of 15,290 AMI patients receiving statins was analyzed from the Korean Myocardial Infarction Registry.
- Patients were categorized into low, normal, and high HDL-C groups based on Adult Treatment Panel III criteria.
- Clinical outcomes, including cardiovascular death and recurrent myocardial infarction, were compared using propensity-adjusted and matched analyses.
Main Results:
- Low HDL-C levels were associated with a significantly increased risk of the primary endpoint (cardiovascular death or recurrent myocardial infarction) in both propensity-adjusted (HR 1.755) and matched (HR 1.716) cohorts.
- High HDL-C levels did not significantly reduce the risk in the propensity-adjusted cohort (HR 0.562) but showed a significant risk reduction in the propensity-matched cohort (HR 0.449).
Conclusions:
- Low HDL-C levels are a significant risk factor for adverse cardiovascular outcomes in AMI patients treated with PCI and statins.
- High HDL-C levels appear to reduce the risk of cardiovascular events, particularly in ST-elevation myocardial infarction patients, warranting further investigation.
Background:
It is unclear whether high-density lipoprotein cholesterol (HDL-C) level predicts cardiovascular events and has a protective effect in patients with acute myocardial infarction (AMI) undergo- ing percutaneous coronary intervention (PCI) and statin treatment.
Methods:
A total of 15,290 AMI patients receiving statins were selected from the Korean Myocardial Infarction Registry. Baseline HDL-C level was used to identify patients with low (group A), normal (group B), and high (group C) HDL-C levels according to the Adult Treatment Panel III criteria. Clinical outcomes were compared in propensity-adjusted and matched cohorts. The primary endpoint was a composite of cardiovascular death and recurrent myocardial infarction.
Results:
At the median follow-up of 11.5 months, the primary endpoint occurred in 2.7% (112/4098), 1.4% (54/3910), and 1.2% (8/661) of patients in groups A, B, and C, respectively. In the propensity- -adjusted cohort, low HDL-C level increased the risk of primary endpoint (hazard ratio [HR] 1.755, 95% confidence interval [CI] 1.274-2.417, p = 0.001), whereas high HDL-C level did not reduce this risk (HR 0.562, 95% CI 0.275-1.146, p = 0.113). In the propensity-matched cohort, low HDL-C level increased the risk of primary endpoint (HR 1.716, 95% CI 1.210-2.434, p = 0.002), whereas high HDL-C level reduced this risk (HR 0.449, 95% CI 0.214-0.946, p = 0.035).
Conclusions:
In AMI patients treated with PCI and statins, low HDL-C level increases the risk of cardiovascular death and recurrent myocardial infarction, whereas high HDL-C level likely reduces the risk of cardiovascular events, especially for ST-elevation myocardial infarction.
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